National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 807348

History of Changes from the VAERS Wayback Machine

First Appeared on 7/14/2019

VAERS ID: 807348
VAERS Form:2
Age:86.0
Sex:Female
Location:Foreign
Vaccinated:2018-11-17
Onset:2018-11-18
Submitted:0000-00-00
Entered:2019-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS 254677 / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Diarrhoea, Fatigue, Feeling cold, Influenza like illness, Pneumonia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2018-12-10
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBSEQIRUS201902657

Write-up: Pneumonia; Feeling cold; Influenza like ilness; Fatigue; Diarrhoea; This is a spontaneous case, reported by other non-healthcare professional (consumer) to regulatory authority and initially retrieved on 18-Mar-2019 by Seqirus from regulatory authority (regulatory reference number: GB-MHRA-EYC 00195192), concerning an 86-year-old, elderly, female patient of weight: 50 kg and height: 157 cm. On 17-Nov-2018, the patient was administered Fluad (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59, dose: 0.5 ml (reported as 1 DF), route of administration: parenteral, batch number: 254677, expiry date and anatomical location: not reported) for influenza immunization. On 18-Nov-2018, one day after vaccination, the patient developed diarrhoea, fatigue, some influenza like illness, pneumonia and was feeling cold. It was reported that, the patient didn''t go out of house between vaccination and her death, however one of the patient''s relative had visited her. On 10-Dec-2018, the patient died mysteriously due to pneumonia suddenly. It was unknown whether autopsy was performed or not. The patient had not recovered from the events feeling cold, flu-like symptoms, fatigue and diarrhoea. The reporter assessed the events as serious (fatal, life-threatening).; Reporter''s Comments: An 86-year-old female patient experienced symptoms of pneumonia and diarrhoea, 1 day after receipt of Fluad TIV. The patient died due to pneumonia, 22 days post vaccination. Considering the plausible temporal relationship between vaccination and reported event, plausible biological mechanism and lack of any underlying conditions or alternative more plausible causes, the company assessed the event diarrhoea as possibly related to suspect vaccine. Considering the onset latency and infectious etiology of the event pneumonia, the causal role of inactivated company suspect vaccine is ruled out. Hence, causality assessed as not related.; Reported Cause(s) of Death: Pneumonia


Changed on 12/24/2020

VAERS ID: 807348 Before After
VAERS Form:2
Age:86.0
Sex:Female
Location:Foreign
Vaccinated:2018-11-17
Onset:2018-11-18
Submitted:0000-00-00
Entered:2019-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS 254677 / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Diarrhoea, Fatigue, Feeling cold, Influenza like illness, Pneumonia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2018-12-10
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBSEQIRUS201902657

Write-up: Pneumonia; Feeling cold; Influenza like ilness; Fatigue; Diarrhoea; This is a spontaneous case, reported by other non-healthcare professional (consumer) to regulatory authority and initially retrieved on 18-Mar-2019 by Seqirus from regulatory authority (regulatory reference number: GB-MHRA-EYC 00195192), concerning an 86-year-old, elderly, female patient of weight: 50 kg and height: 157 cm. On 17-Nov-2018, the patient was administered Fluad (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59, dose: 0.5 ml (reported as 1 DF), route of administration: parenteral, batch number: 254677, expiry date and anatomical location: not reported) for influenza immunization. On 18-Nov-2018, one day after vaccination, the patient developed diarrhoea, fatigue, some influenza like illness, pneumonia and was feeling cold. It was reported that, the patient didn''t go out of house between vaccination and her death, however one of the patient''s relative had visited her. On 10-Dec-2018, the patient died mysteriously due to pneumonia suddenly. It was unknown whether autopsy was performed or not. The patient had not recovered from the events feeling cold, flu-like symptoms, fatigue and diarrhoea. The reporter assessed the events as serious (fatal, life-threatening).; Reporter''s Comments: An 86-year-old female patient experienced symptoms of pneumonia and diarrhoea, 1 day after receipt of Fluad TIV. The patient died due to pneumonia, 22 days post vaccination. Considering the plausible temporal relationship between vaccination and reported event, plausible biological mechanism and lack of any underlying conditions or alternative more plausible causes, the company assessed the event diarrhoea as possibly related to suspect vaccine. Considering the onset latency and infectious etiology of the event pneumonia, the causal role of inactivated company suspect vaccine is ruled out. Hence, causality assessed as not related.; Reported Cause(s) of Death: Pneumonia


Changed on 12/30/2020

VAERS ID: 807348 Before After
VAERS Form:2
Age:86.0
Sex:Female
Location:Foreign
Vaccinated:2018-11-17
Onset:2018-11-18
Submitted:0000-00-00
Entered:2019-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS 254677 / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Diarrhoea, Fatigue, Feeling cold, Influenza like illness, Pneumonia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2018-12-10
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBSEQIRUS201902657

Write-up: Pneumonia; Feeling cold; Influenza like ilness; Fatigue; Diarrhoea; This is a spontaneous case, reported by other non-healthcare professional (consumer) to regulatory authority and initially retrieved on 18-Mar-2019 by Seqirus from regulatory authority (regulatory reference number: GB-MHRA-EYC 00195192), concerning an 86-year-old, elderly, female patient of weight: 50 kg and height: 157 cm. On 17-Nov-2018, the patient was administered Fluad (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59, dose: 0.5 ml (reported as 1 DF), route of administration: parenteral, batch number: 254677, expiry date and anatomical location: not reported) for influenza immunization. On 18-Nov-2018, one day after vaccination, the patient developed diarrhoea, fatigue, some influenza like illness, pneumonia and was feeling cold. It was reported that, the patient didn''t go out of house between vaccination and her death, however one of the patient''s relative had visited her. On 10-Dec-2018, the patient died mysteriously due to pneumonia suddenly. It was unknown whether autopsy was performed or not. The patient had not recovered from the events feeling cold, flu-like symptoms, fatigue and diarrhoea. The reporter assessed the events as serious (fatal, life-threatening).; Reporter''s Comments: An 86-year-old female patient experienced symptoms of pneumonia and diarrhoea, 1 day after receipt of Fluad TIV. The patient died due to pneumonia, 22 days post vaccination. Considering the plausible temporal relationship between vaccination and reported event, plausible biological mechanism and lack of any underlying conditions or alternative more plausible causes, the company assessed the event diarrhoea as possibly related to suspect vaccine. Considering the onset latency and infectious etiology of the event pneumonia, the causal role of inactivated company suspect vaccine is ruled out. Hence, causality assessed as not related.; Reported Cause(s) of Death: Pneumonia


Changed on 5/7/2021

VAERS ID: 807348 Before After
VAERS Form:2
Age:86.0
Sex:Female
Location:Foreign
Vaccinated:2018-11-17
Onset:2018-11-18
Submitted:0000-00-00
Entered:2019-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS 254677 / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Diarrhoea, Fatigue, Feeling cold, Influenza like illness, Pneumonia

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2018-12-10
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBSEQIRUS201902657

Write-up: Pneumonia; Feeling cold; Influenza like ilness; Fatigue; Diarrhoea; This is a spontaneous case, reported by other non-healthcare professional (consumer) to regulatory authority and initially retrieved on 18-Mar-2019 by Seqirus from regulatory authority (regulatory reference number: GB-MHRA-EYC 00195192), concerning an 86-year-old, elderly, female patient of weight: 50 kg and height: 157 cm. On 17-Nov-2018, the patient was administered Fluad (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59, dose: 0.5 ml (reported as 1 DF), route of administration: parenteral, batch number: 254677, expiry date and anatomical location: not reported) for influenza immunization. On 18-Nov-2018, one day after vaccination, the patient developed diarrhoea, fatigue, some influenza like illness, pneumonia and was feeling cold. It was reported that, the patient didn''t go out of house between vaccination and her death, however one of the patient''s relative had visited her. On 10-Dec-2018, the patient died mysteriously due to pneumonia suddenly. It was unknown whether autopsy was performed or not. The patient had not recovered from the events feeling cold, flu-like symptoms, fatigue and diarrhoea. The reporter assessed the events as serious (fatal, life-threatening).; Reporter''s Comments: An 86-year-old female patient experienced symptoms of pneumonia and diarrhoea, 1 day after receipt of Fluad TIV. The patient died due to pneumonia, 22 days post vaccination. Considering the plausible temporal relationship between vaccination and reported event, plausible biological mechanism and lack of any underlying conditions or alternative more plausible causes, the company assessed the event diarrhoea as possibly related to suspect vaccine. Considering the onset latency and infectious etiology of the event pneumonia, the causal role of inactivated company suspect vaccine is ruled out. Hence, causality assessed as not related.; Reported Cause(s) of Death: Pneumonia

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=807348&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166